Does E22.0 require prior authorization?

No, E22.0 does not require prior authorization (high confidence). Code is covered without prior authorization.

`E22.0` — Acromegaly and pituitary gigantism

ICD-10-CM

No Prior Auth Required

Code is covered without prior authorization (high confidence)

For CID codes (T38.895*/T43.215*/T43.225*/T50.995*), the medical record must document the specific chemotherapy agent(s) causing the diarrhea and prior antidiarrheal treatments that have been ineffective.
For VIPoma diagnosis codes (C25.4, C26.0, D13.7, D13.91, D13.99), the medical record must document that the patient’s diagnosis is VIPoma.
When code R79.89 is used, the medical record must document the abnormal clinical or laboratory findings that prompted suspicion of VIPoma.
When code R94.7 is used, the medical record must document an abnormal octreotide scan that prompted suspicion of VIPoma.

Octreotide is covered for chemotherapy-induced diarrhea (CID) when claim includes ICD-10-CM codes T38.895A/T38.895D/T38.895S, T43.215A/T43.215D/T43.215S, T43.225A/T43.225D/T43.225S, or T50.995A/T50.995D/T50.995S and the medical record documents the chemotherapy agent(s) causing the CID and prior antidiarrheal treatments that became ineffective.
Octreotide is covered for treatment of VIPoma when claim includes ICD-10-CM codes C25.4, C26.0, D13.7, D13.91, or D13.99 and the medical record documents that the patient’s diagnosis is VIPoma.
Octreotide may be considered when ICD-10-CM code R79.89 is submitted if the medical record documents abnormal clinical or laboratory findings that led to suspicion of VIPoma.
Octreotide may be considered when ICD-10-CM code R94.7 is submitted if the medical record documents an abnormal octreotide scan that led to suspicion of VIPoma.
Coverage for thoracic aortography and carotid, vertebral, and subclavian angiography is determined by Local Coverage Determination L35035; services are covered when reasonable and necessary per that LCD.
Visual field testing is covered when billed to the Part A or Part B MAC with a valid ICD-10-CM diagnosis code that best describes the patient’s condition and when the service is reasonable and necessary.

L33574 — Visual Fields Testing

J06

A56551 — Billing and Coding: Visual Fields Testing

J06

L36767 — Aortography and peripheral angiography

J09

A57056 — Billing and Coding: Aortography and Peripheral Angiography

J09

L35049 — Monitored Anesthesia Care

Ask Verity about documentation requirements, denial risks, or coverage in your state.